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John Edwards made a fine speech in New Orleans yesterday announcing the end of his presidential campaign. He said that he would continue working toward his goal of ending poverty in the United States, and that both Barack Obama and Hillary Clinton personally promised him they would make that goal an integral part of their own campaigns and their prospective presidencies.

Welcome to 1964.

It was 44 years ago this month that Lyndon Johnson used his first State of the Union speech to declare "unconditional war on poverty in America." Johnson said that his budget and legislative proposals, which included the Economic Opportunity Act of 1964, were "designed to help each and every American citizen fulfill his basic hopes--his hopes for a fair chance to make good; his hopes for fair play from the law; his hopes for a full-time job on full-time pay; his hopes for a decent home for his family in a decent community; his hopes for a good school for his children with good teachers; and his hopes for security when faced with sickness or unemployment or old age."

The poverty rate stood at nearly 20% when Johnson inherited the presidency; a decade later it was barely more than half that, a historic low which hasn't been matched since.

Edwards acknowledged the time warp when he said that "I don't know when our party began to turn away from the cause of working people, from the fathers who were working three jobs literally just to pay the rent, mothers sending their kids to bed wrapped up in their clothes and in coats because they couldn't afford to pay for heat."

As it happens, through the magic of the Wayback Machine we can pretty much pinpoint the moment: March, 1985.

The trouble with the Democratic Party is that to many voters its national leadership appears to be no more than a collection of shrill special-interest groups. Just look at the way the Democratic National Committee has not merely tolerated but officially recognized seven different caucuses, representing business, women, blacks, Hispanics, Asian-Pacific delegates, "liberal- progressives" and even homosexuals.

That, at least, is the bitter complaint of some of the party's prominent elected officials. Their solution? To form another caucus, of course, this one composed primarily of Southern and Western white males and operating outside, if not in opposition to, the National Committee.

To be sure, that is not the official logic of the Governors, Senators and Representatives who have organized the Democratic Leadership Council. Their stated purpose "is to move the party back to the middle," in the words of Florida Senator Lawton Chiles, by developing centrist policy positions. In their view the party must shed its ultraliberal, antibusiness, soft-on-defense image if it is ever to win back the voters who have been defecting and, in particular, if it is to enter future presidential elections without almost automatically forfeiting the electoral votes of Southern and Western states. To accomplish that, say council promoters, requires an organized group arguing within the party for positions favoring economic growth, a strong defense and a tough stance against crime.

A return to the war on poverty isn't the only vivid flashback of this campaign season. I'd be surprised if Ted Kennedy didn't experience some serious deja vu as he pondered endorsing Barack Obama; almost exactly 37 years ago, Kennedy received prominent placement in a New York Times editorial on one of his and now Obama's signature issues.

President Nixon's proposals for a reorganization of the United States health care system represent a creative and useful contribution to the growing national debate on this topic. Up to now public discussion of the subject has largely turned on the merits and defects of national health insurance, as projected, for example, by Senator Kennedy. Mr. Nixon has offered a serious alternative which attempts to minimize direct government intervention and expenditure, while taking advantage of the indubitable strengths of the existing system.

The Nixon plan, which was, as the Times hints, meant to forestall national health insurance at a moment when some sort of significant health care reform seemed inevitable, bears considerable resemblance to the Obama plan. Here's a description of the major points from a March 1, 1971 Time Magazine story, which begins by saying "In the U.S. today, only the rich can afford to be ill; even the modestly well-off may not be able to bear the financial burden of a long, debilitating illness."

  • The major burden of increased medical costs would fall on U.S. employers, large and small, who would be required to provide alt employees with a health-insurance plan that includes hospitalization and major-medical, maternity and pediatric benefits, plus catastrophic-illness coverage to the tune of $50,000 a year. The program would cost employers at least $2.5 billion a year—and the Government at least $2 billion, since their outlays would be taxdeductible. Employees would be required to pay 25% of the cost. Such a system would cover 150 million Americans, including 10 million working poor who now have no coverage at all.

  • The Federal Government would pay either all or a substantial part of the cost of health insurance for some 5.3 million low income, largely nonworking families through a new Family Health Insurance Plan. Under it, families with incomes below $3,000 a year would be given the equivalent of a $600 annual premium in private insurance; those earning up to $5,000 would be required to make at least token payments toward the policies.

  • The Government would pick up the entire $1.4 billion annual tab for the Part B supplement to Medicare, which now covers doctor bills and outpatient services for nearly 20 million of the program's participants. As a result, the elderly who now pay $5.30 a month for the supplemental coverage would receive what amounts to an average 5% increase in Social Security benefits.

  • Grants totaling $23 million, plus loan guarantees for buildings and working capital, would be made available to encourage formation of prepaid health-maintenance organizations like California's Kaiser Plan. Such groups, which provide broad medical and preventive health services for fixed annual fees, now cover 7,000,000 Americans. Some Administration officials believe that the plans can reduce by half the average number of days that patients spend in hospitals.

  • Funds totaling nearly $100 million would be made available to encourage medical schools to train more doctors and allied health personnel. Direct grants and financial incentives would be offered to doctors to form group practices or work in ghettos and rural communities, and $15 million would be set aside to establish family health centers in areas where medical facilities are scarce.

  • Efforts would be made to reduce overall medical costs by developing preventive-care programs and thus cutting down on hospital admissions. A watchdog commission, added to the Administration proposals as an eleventh-hour afterthought, would have regulatory power over the private health-insurance industry, including authority to prevent unwarranted increases in coverage costs.


Prospects for passage of the Nixon plan are good. Most Congressmen are prepared to vote for some expansion of health coverage, and even the most conservative know that they must go further than the A.M.A.'s offering if they are to satisfy their constituents in 1972. Only the more liberal are willing to go along with Kennedy and approve a plan that even backers admit could cost $57 billion to put into operation; critics estimate that it could require as much as $77 billion, though not all in new money. The majority of Congressmen are likely to find Nixon's remedy, which will cost only $3 billion in new Government moneys, an acceptable middle way in a situation where they must take some action before facing the voters in 1972.

Kennedy eventually backed off the universal coverage plan sponsored by him in the Senate and Representative Martha Griffiths in the House and substituted a less comprehensive plan that was deemed more acceptable, but by then Watergate had caught fire and House Ways and Means chairman Wilbur Mills, who opposed the Kennedy-Griffiths plan but wanted to pass something, drove Fanne Fox and his career into the Tidal Basin, and the momentum just sort of faded away.

Good times. And they're back.

Despite Nixon's and Mill's bad luck, the issue was still a hot topic when Gerald Ford took office, and he addressed it in his second State of the Union speech. (The first was more focused on He Who Must Not Be Named and stuff like building 200 new nuclear power plants by 1985.)

Hospital and medical services in America are among the best in the world, but the cost of a serious and extended illness can quickly wipe out a family's lifetime savings. Increasing health costs are of deep concern to all and a powerful force pushing up the cost of living. The burden of catastrophic illness can be borne by very few in our society. We must eliminate this fear from every family.

I propose catastrophic health insurance for everybody covered by Medicare. To finance this added protection, fees for short-term care will go up somewhat, but nobody after reaching age 65 will have to pay more than $500 a year for covered hospital or nursing home care, nor more than $250 for 1 year's doctor bills.

We cannot realistically afford federally dictated national health insurance providing full coverage for all 215 million Americans. The experience of other countries raises questions about the quality as well as the cost of such plans. But I do envision the day when we may use the private health insurance system to offer more middle-income families high quality health services at prices they can afford and shield them also from their catastrophic illnesses.

Is this sounding familiar?

Edwards deserves credit for moving Obama and Clinton off dead center on economic issues, but it's somewhat tragic that he set the health care bar so low for his competitors. His plan is somewhat better than Clinton's, and Clinton's is somewhat better than Obama's, but all three versions share that resemblance to the plan Nixon came up with to avoid instituting the genuinely comprehensive solution he saw coming down the pike.

And of course Kennedy's plan wasn't by any means the first of its kind; Truman introduced his own version of the beast in 1945, and went down in flames before an onslaught conducted largely by the American Medical Association in association with insurers, pharmaceutical firms and your friendly neighborhood Chamber of Commerce.

By the time Eisenhower took office, national health coverage was firmly associated with the Red Menace; it would be another dozen years before the idea began to regain some traction in the form of Medicare.

All of which is by way of explanation as to why incrementalism leaves me cold, not to mention all too often unmedicated. If the starting point for reform is an unambitious plan consisting of dozens of moving parts, each of which can be tinkered with by lobbyists and their Congressional factotums, the ending point, if there is one, will probably qualify as reform only in the most literal sense; the system may not be better, but it will be reformed in the sense that it doesn't look exactly like it used to.

One more little echolaliac irony to share on all this, on Kennedy again, from the Times again.

Discussing his approach to the Nixon Administration from his new position as Democratic whip, or assistant leader, of the Senate, Senator Kennedy said in an interview: "We are in an entirely different period than in the 1950's, when Bob Taft said, 'The role of the opposition is to oppose.' The country, given the kinds of problems we have today, cannot afford that attitude.

"I think the President will find a responsible kind of support on the Democratic side. We will come up with responsible alternatives but at the same time there will be a willingness to give the President the benefit of the doubt."

One might begin to wonder if the Kennedy endorsement isn't as much a ritual hazing of the new guy as a genuine expression of enthusiasm.

So why, you might reasonably ask, would I recommend voting for Obama when I so clearly doubt his commitment to Sparkle Motion? The answer, of course, is to be found not in who he is but in who he isn't: the leading recipient of campaign cash from pharmaceutical firms, hospitals and nursing homes, HMOs, insurance companies, and lobbyists of all stripes, the declared darling of the DLC, and someone with nearly two decades of freeze-dried smears poised to be unleashed against him.

Clinton's campaign has raked in nearly $300,000 from drug companies, $250,000 from HMOs and other service providers, more than $500,000 from insurance companies and more than $500,000 from lobbyists.

Obama isn't all that far behind her in those categories—except for the lobbyists, because he only accepts money from their spouses and clients, not them—and he'll certainly surpass her if he wins the nomination, but the depth of their affection for Clinton seems truly profound.

Beyond that, we've been through the wars with the Clintons already. We're headed for one of the ugliest campaigns in a century or so no matter if it's the broad or the colored guy, and while the bile that awaits Obama isn't anything generically new, it won't be a verbatim rehash of the 1990's.

It'll be fresh bile, to the extent that a zesty combination of xenophobia and 130 years of poorly suppressed, richly textured and gleefully exploited Reconstruction resentment can be called fresh. We deserve fresh bile. And there's always the chance that surviving that sort of abuse might create the man that his supporters think he already is.

Worst case, we get a shot at finally implementing Dick Nixon's social engineering agenda, but without the raging paranoia. He could even hire Rudy Giuliani and have an FBI director who wears a dress.

**If you've read this far and haven't figured out yet who will have soon forgotten Edwards, I'm sorry, but union rules forbid further explication.

Cross-posted at BTC News

Originally posted to weldon berger on Thu Jan 31, 2008 at 09:23 AM PST.

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